Provider Demographics
NPI:1134509334
Name:VICTORIA ROSATI, OD
Entity Type:Organization
Organization Name:VICTORIA ROSATI, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:519-965-1081
Mailing Address - Street 1:1855 NORMANDY ST UNIT 605
Mailing Address - Street 2:
Mailing Address - City:LASALLE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N9H2R4
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:503 SANDWICH ST S
Practice Address - Street 2:
Practice Address - City:AMHERSTBURG
Practice Address - State:ONTARIO
Practice Address - Zip Code:N9V3G5
Practice Address - Country:CA
Practice Address - Phone:519-736-5422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ12048261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care